Introducing occupational health

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Introducing occupational health Part 2
Grant McMillan Hon Senior Clinical Lecturer
Institute of Occupational and Environmental
Health University of Birmingham Number 2 of a
series of lectures and tutorials for medical
undergraduates
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Learning Points

• Concept of hazard and risk
• Hazards of some specific occupations
• Matching people to jobs jobs to people
• Assisting return to work of sick and injured
• Keeping patients at work
• Promoting wellness
• Additional handouts electronic and hard copy
  handouts are available on taking and using an
  occupational history

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Basic tasks of an Occupational Health Service

• Hazard identification and risk assessment
• Risk control or management
• Matching people to jobs jobs to people
• Keeping patients at work
• Assisting return to work of sick and injured
• Promoting wellbeing at work

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Concept of hazard and risk
Hazard Any exposure that might cause harm
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Concept of hazard and risk
Risk The chance of that harm occurring in given
circumstances
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Risk assessment and risk management

• Identify hazards
• Assess risks to health in the circumstances
• Consider workers and general population
• Control risks to an acceptable level

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Classes of hazards

• Chemical
• Physical
• Mechanical and ergonomic
• Biological
• Psycho-social/organisational

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Nature of exposures

• Acute short period
• Chronic long period

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Sites of exposures

• Confined within workplace
• Vented from workplace
• Carried from workplace
• Domestic
• Leisure

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CHEMICAL EXPOSURES

• Hairdressers
• Farmers
• Cleaners
• Builders
• Healthcare workers

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(No Transcript)
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Hazard cement is highly alkaline Effect -
acute irritant dermatitis cement burn
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PHYSICAL EXPOSURES

• Heat welders, soldiers, ex-pats
• Cold fishermen, storemen
• Noise airport workers, road repairs
• Vibration miners, fabrication workers
• Radiation radiographers, welders
• Lifting nurses

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Descending order of new cases of work-related
illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory diseases incl asthma
• Infections

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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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• Typists have x18 population risk of absence
  due to musculoskeletal disease

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Musculoskeletal fitness is critical to a wide
range of occupations
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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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500,000 people in Great Britain in 2002/03
believed they were experiencing work-related
stress that was making them ill.
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• NCOs and other ranks
• in the Armed Forces
• have x15 population risk of mental illness

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• NCOs and other ranks
• in the Armed Forces
• - mainly anxiety and depression

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• Doctors x 12

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Teachers and Prison Service x9
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Police x8
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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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• Florists and floral arrangers x14

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Hairdressers and beauticians x13
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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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Vehicle spray painter x80 for asthma
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Baker x50 risk of asthma
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(No Transcript)
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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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Ensure occupational history includes unusual
occupations eg Rosie the Riveter during WW2
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(No Transcript)
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Effects of vibration on fingers Hand Arm
Vibration Syndrome
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Work-related illnesses seen by specialist doctors

• Musculoskeletal disorders
• Mental ill health
• Skin diseases
• Respiratory including asthma
• Noise and vibration
• Infections

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Fishmonger x25 risk of infection
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What hazards a medical student might meet at work
?

• Sources of hazards patients,
  investigations, therapeuti
  c agents
• environment
• Most important include infectious agents
• anaesthetic agents
• antineoplastic drugs
• ionising radiation
• violence

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Basic tasks of an Occupational Health Service

• Hazard identification and risk assessment
• Risk control or management
• Matching people to jobs jobs to people
• Keeping patients at work
• Assisting return to work of sick and injured
• Promoting wellbeing at work

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Matching jobs and people

• People health, fitness, susceptibilities
• Jobs Ergonomics minimising risks
• Psychosocial work-life balance, stress
• Evidence-based standards
• Common sense

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Basic tasks of an Occupational Health Service

• Hazard identification and risk assessment
• Risk control or management
• Matching people to jobs jobs to people
• Keeping patients at work
• Assisting return to work of sick and injured
• Promoting wellbeing at work

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Assisting stay at or return to work
What is the patients occupation? Are there
patient factors which might impede the patient
returning to work or remaining at work during
treatment? Are there treatment factors which
might impede the patient returning to work or
remaining there during treatment? Are there
work factors which might impede the patient
returning to work or remaining there during
treatment?
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Getting people back to work

• Feature the need to return to work in the
  patients treatment plan from the outset
• Actively involve the patient in developing the
  plan for return to the work they want to do or
  need to do

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Getting people back to work

• Determine level of motivation and confidence
• Boost motivation and restore lost confidence

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Getting people back to work

• As appropriate, and with the informed consent of
  the worker, involve the employer
• Perhaps ask experts to conduct holistic
  assessments.

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• This may require an informal or formal
  assessment of the work.

• Content

• Load

• Pattern - shifts, part time, home working

• Environment

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• Help workers to be fit

• Promote healthy lifestyle
• smoking cessation
• diet and obesity control
• exercise
• reduce stress-causing pressures

• Improve self-perception of health and fitness

• Encourage leisure exercise

• Encourage exercise at work - stairs vs lifts,
• changing rooms and showers, gym

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Learning Points

• Concept of hazard and risk
• Hazards of some specific occupations
• Matching people to jobs jobs to people
• Assisting return to work of sick and injured
• Keeping patients at work
• Promoting wellness
• Additional handouts electronic and hard copy
  handouts are available on taking and using an
  occupational history

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QUESTIONS TO BURN INTO YOUR MIND

• DO YOU GO OUT TO WORK?
• WHAT DO YOU DO AT WORK?
• WHAT WORK DO YOU DO AT HOME?

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Introducing occupational health Part 2
Grant McMillan Hon Senior Clinical Lecturer
Thank you for your attention